The existing page on whether pilgrimages are good for seniors answers the yes-or-no question; this page is about what to ask a company. Start with pace. Ask for the itinerary with walking distances and the number of days that start before eight. One base for three or more nights is easier than a new hotel every night, and a settled shrine stay beats a multi-city route. Ask whether the coach drops at the door or at a distant bus park, as at St. Peter's and Assisi.
Hotels matter more than ratings suggest. Ask specifically whether each hotel has an elevator, walk-in showers, and air conditioning, and how far it is from the shrine. At Lourdes the sanctuary runs a reception for disabled persons and lists health professionals who work in hotels, which is why many companies recommend it for older pilgrims. At Fátima the shrine's pilgrim service has special programs for the sick.
On medical matters, ask the company what happens if a pilgrim falls ill: who accompanies them, whether a staff member stays behind, and whether the guide carries contact details for English-speaking doctors. The State Department warns that air-ambulance evacuation to the United States is expensive and recommends evacuation coverage; some companies include it and some require proof of purchase. Carry a list of medications and copies of prescriptions, and check with the embassy of each country for restricted drugs.
Finally, ask who else is on the trip; a mixed-age group moves at its fastest members' pace unless the leader rules otherwise in advance.